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	 <H2 ALIGN="CENTER">Chinese Cultural Centre Survey</H2> 
	 <P><FONT FACE="Arial" SIZE="-1">Aliana Pong, Program Co-ordinator at the
		Chinese Cultural Centre would like to develop further programs for Families
		with Children from China. In order to best meet our needs Aliana needs
		information from us regarding our wishes. Please complete the following survey
		and return to Wanda Pierson, 58-9000 Ashgrove Cres., Burnaby, B.C., V5A 4M5, or
		e-mail <A HREF="mailto:wpierson@langara.bc.ca">Wanda</A> by November 26, 2001.
		</FONT></P> 
	 <P ALIGN="center"><FONT FACE="Arial" SIZE="-1"><U>When completing the
		questionnaire please indicate the option for each statement you most prefer</U>
		</FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">1. Would your family like to participate in
		a cultural camp sponsored by the Chinese Cultural Centre?
		<FONT FACE="wingdings">o</FONT><FONT>Yes </FONT><FONT
		FACE="wingdings">o</FONT><FONT>No </FONT></FONT></P> 
	 <P><FONT SIZE="2" FACE="Arial">2. How many days would you like to have the
		camp offered? </FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings"
		SIZE="3">o</FONT><FONT> 1 week </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> 4
		days </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> 3
		days </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> 2
		days </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> 1 day
		</FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> other
		____________________________________ </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT SIZE="2"></FONT><FONT SIZE="3">3. How
		many hours each day would you like to have the camp offered? </FONT></FONT></P>
	 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> 9:30
		am to 12:30 am </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> 1 pm
		to 4 pm </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> 9:30
		am to 4 pm </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT>
		other______________________________________ </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">4. What type of activities would you like
		to have offered at the camp? Please indicate all the activities you would wish
		to have. </FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT>
		Mandarin instruction </FONT><FONT FACE="wingdings">o</FONT><FONT> Calligraphy
		</FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT>
		Chinese Crafts </FONT><FONT FACE="wingdings">o</FONT><FONT> Chinese Music
		</FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> Folk
		Stories </FONT><FONT FACE="wingdings">o</FONT><FONT> Chinese Allusion
		</FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT>
		Chinese Games </FONT><FONT FACE="wingdings">o</FONT><FONT> Chinese Dance
		</FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">Please list all other activities you would
		like to have offered. </FONT></P> 
	 <P><FONT FACE="Arial"
		SIZE="-1">_____________________________________________________________
		</FONT></P> 
	 <P><FONT FACE="Arial"
		SIZE="-1">_____________________________________________________________
		</FONT></P> 
	 <P><FONT FACE="Arial"
		SIZE="-1">_____________________________________________________________
		</FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">5. Would your family like to participate in
		a cultural camp during Spring Vacation </FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">(March 18-22)? <FONT
		FACE="wingdings">o</FONT><FONT>Yes </FONT><FONT
		FACE="wingdings">o</FONT><FONT>No </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">6. Would your family be interested in
		participating in a cultural camp during the Christmas Vacation (December
		24-January 4) <FONT FACE="wingdings">o</FONT><FONT>Yes </FONT><FONT
		FACE="wingdings">o</FONT><FONT>No </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">7. Would your family be interested in
		participating in a cultural camp during the Easter Vacation (March 29-April 1)
		<FONT FACE="wingdings">o</FONT><FONT>Yes </FONT><FONT
		FACE="wingdings">o</FONT><FONT>No </FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">8. Please indicate when during the summer
		months might be best time for your family to participate in a cultural camp.
		</FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT>
		Beginning of July </FONT><FONT FACE="wingdings">o</FONT><FONT> Middle of July
		</FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT> End
		of July </FONT><FONT FACE="wingdings">o</FONT><FONT> Beginning of August
		</FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1"><FONT FACE="wingdings">o</FONT><FONT>
		Middle of August </FONT><FONT FACE="wingdings">o</FONT><FONT> End of August
		</FONT></FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">Please indicated the ages of the children
		you would have attend the cultural camp. </FONT></P> 
	 <P><FONT FACE="Arial"
		SIZE="-1">__________________________________________________________________
		</FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">All cultural camp activities will likely
		occur at the Chinese Cultural Centre. Your answers to this questionnaire will
		greatly facilitate planning. Please take a moment to complete the document.
		Thank you for your time and assistance. </FONT></P> 
	 <P><FONT FACE="Arial" SIZE="-1">Wanda Pierson &amp; Al Aliana Pong
		</FONT></P> 
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